How is the front hairline designed in a hair transplant?

What is hairline design?

The front hairline is the border between your forehead and your scalp, and it forms the upper frame of your face. In a hair transplant, deciding where this border will run, what shape it will take and how it will look up close is what we call hairline design. Because this is the most noticeable part of the recipient area, the design is one of the most important steps of the plan.

If you look closely at a hairline without hair loss, you will not see a line drawn with a ruler; in the design, we take this natural structure as our model. We have summarized the guiding concepts in the table below. They are not rules; they are starting points that we adapt to your face, your hair type and the course of your hair loss.

How is the height of the hairline determined?

The design often starts with the midfrontal point; when choosing where it goes, we look at several guides together:

• The three sections of the face: The face is roughly divided into three sections: from the hairline to between the eyebrows, from there to the base of the nose, and from the base of the nose to the tip of the chin. When these sections are close to each other in height, most faces look balanced; bringing the hairline very low and markedly shortening the upper section, on the other hand, often looks out of keeping on an adult face.
• The slope of the forehead: As the forehead rises, at a certain point it curves back toward the top of the head. Placing the hairline well below this curve moves the hair onto the vertical part of the forehead, which may not look natural, especially from the side.
• Distance from the eyebrows: We also look at the distance from the midfrontal point to the point between the eyebrows. However, there is no fixed measurement that suits everyone; the same distance can look very different on two different faces.
• Your former hairline: The fine hairs left at the top of your forehead and old photos of you can give an idea of where your hairline was before the hair loss. Even so, the goal is not always to return to your former hairline.

The temple corners: the frontotemporal angle and the shape of the hairline

As the hairline runs from the front center toward the sides, at a certain point it turns back toward the temples. This corner is called the frontotemporal angle (where the front hairline meets the temple hairline). In male pattern hair loss, recession often starts at these corners; in everyday language, this is called “receding temples.”

In most adult men, these corners sit slightly further back than the midfrontal point; the hairline is not a straight line but an arc that curves gently back toward the sides. Filling in the corners completely and drawing the hairline as a straight, low line imitates the hairline of early youth; in later years, this look may no longer suit your face.

When we decide where the corners will go, we look at the position of your eyes and eyebrows, where your temple hair begins and how the hair loss is progressing in this area. Because faces are not perfectly symmetrical, the two corners do not need to be exactly the same; even so, we make sure the two sides look balanced with each other.

In women, the hairline is usually more rounded, blends softly into the temples and generally has no distinct receding corner. We cover lowering a high hairline with grafts on a separate page, hairline lowering with a hair transplant.

The transition zone and irregularity: why isn’t the hairline straight?

At the front of a natural hairline, there is a strip where the hair starts out sparse and becomes gradually denser toward the back; this is called the transition zone. Behind it is the part where the hair reaches its full density. From a distance, it is mostly this part that we perceive as the border; the transition zone softens that border.

Natural hairlines show two types of irregularity:

• Macro-irregularity (irregularity in the overall line): Even from a distance, the hairline is not completely straight; in places, it comes slightly forward or goes slightly back. In the design, we plan these indentations and projections as soft waves, without exaggerating them.
• Micro-irregularity (irregularity in the arrangement of the hairs): Up close, the hairs are not lined up in rows; the spacing between them is irregular, and some hairs stand alone, slightly in front of the line. This is why we place the grafts in the transition zone at irregular intervals rather than in straight rows.

Why are single-hair grafts used at the front edge?

On the scalp, hair mostly grows in small groups in which one to four hairs emerge together; these are called follicular units (natural hair groups). We explain why grafts are taken in these groups in our article on grafts and follicular units.

At the very front of a natural hairline, there are mostly single-hair units. That is why we place single-hair grafts at the front edge and grafts with progressively more hairs further back; this way, the density increases from front to back. A multi-hair graft placed at the very front, by contrast, can look like a tuft.

The angle and direction of the grafts matter as much as the number of hairs they carry. At the front edge, the hairs emerge from the skin at a shallow angle, lying close to it, and mostly point forward; closer to the temples, their direction gradually turns to the side and downward. We place the grafts so that they follow this direction; we describe the placement options on our hair transplant methods page.

Your hair type also affects the design. Thick, dark hairs stand out more against light skin; in that case, the transition zone and the arrangement of the single-hair grafts need extra care. With fine, light-colored or curly hair, the transition often looks softer.

Design for your age: thinking about today and the years ahead together

In most men, the hairline moves up somewhat after puberty, and the temple corners move slightly back. This is called hairline maturation, and it does not always mean hair loss. A mature hairline usually suits an adult face better.

Male pattern hair loss, on the other hand, often progresses over the years; how fast varies from person to person. The transplanted hair is taken from the donor area, which is less sensitive to hair loss, and usually keeps this property; however, your own hair behind the hairline may continue to thin. If a very low hairline with filled-in corners is designed today, you may later be left with a dense strip at the front and a sparse area behind it once the hair there thins. Because the donor area is limited, it may not always be possible to fill this area later.

That is why we choose a position for the hairline that can stay in harmony with your face in the years ahead too. We are more cautious with people who are young and whose hair loss is progressing quickly; we discuss the role of age in planning in our article on age and hair transplants. For some people, medical treatment for hair loss may also be considered alongside the transplant; this decision is made based on your doctor’s assessment.

A hairline designed too low is not easy to move up later. A conservative hairline, on the other hand, is usually easier to bring a little lower later with an additional procedure, if your donor area allows.

What do the measurements not tell us?

The measurements have their limits too:

• There is no single formula that suits everyone. These measurements are largely based on observations of hairlines in people without hair loss and on doctors’ practical experience; they are not strict rules to be applied the same way to every face. The shape of the hairline can vary considerably from person to person and with ethnic background.
• The course of hair loss cannot be known for certain in advance. Family history and the current picture give only an indication of how much and how fast it will progress.
• The design alone does not determine the result. How the hairline will look also depends on how well the grafts take, how you heal, your hair type and the number of grafts your donor area can provide. The density you want at the front edge may not be achievable in a single session. New hair also takes months to grow, and when the hairline becomes clearly defined varies from person to person. We explain the other factors that affect how it looks in our article on whether a hair transplant looks natural.
• Taste is personal. Even a hairline that fits the measurements may not meet everyone’s expectations; that is why we create the design by talking it through with you.

How do we design your hairline together during the examination?

You design your hairline together with the doctor who examines you. During the examination, we first listen to your expectations, and then we look at the following together:

• The pattern of your hair loss, how long it has been going on, and your family history of hair loss
• Your facial proportions, the slope of your forehead, and the position of your eyebrows and temples
• The thickness, color and curl of your hair, and the color contrast between your hair and your skin
• The density of your donor area and how many grafts it can provide today and in the future

We then draw the proposed hairline on your skin and assess it together in the mirror, from the front and from the side. If needed, we adjust it and draw it again. We settle on the final hairline with your approval before the procedure begins.

Whether you are suitable for a hair transplant is determined during the examination, and results vary from person to person.